脂蛋白相关磷脂酶A2水平与动脉粥样硬化斑块形成、稳定型及病变程度关系的探讨

Relationship between lipoprotein associated phospholipase A2 and coronary artery disease

目的:探讨血清脂蛋白相关磷脂酶A2(LP-PLA2)水平与冠状动脉病变的相关性及临床意义。方法:收集202例确诊或疑诊冠心病而行冠状动脉造影检查患者的病历资料。依据患者冠状动脉造影检查结果,将所有入选者分为对照组和实验组。对照组为冠脉造影堵塞<50%者;实验组根据临床症状分为不稳定心绞痛、稳定型心绞痛以及急性心肌梗死组,根据病变情况分为单支、双支及三支病变组。比较各组LP-PLA2水平,并计算Gensini积分,探讨各组患者血清LP-PLA2水平与Gensini积分的关系。结果:(1)冠状动脉病变组的血清LP-PLA2水平显著高于对照组(P<0.05),实验组中,急性心肌梗死组血清LP-PLA2水平最高。(2)单支、双支及三支病变组间的血清LP-PLA2水平差异无统计学意义。(3)血清LP-PLA2水平与冠状动脉Gensini评分存在正相关关系,Gensini评分越高,LP-PLA2水平越高。结论:血清LP-PLA2水平与冠状动脉病变程度具有一定的相关性,检测血清LP-PLA2水平可用于评估冠状动脉病变的进展。

Objective： To investigate the correlation between lipoprotein associated phospholipase A2（ LP-PLA2） concentration and coronary artery lesions,and to explore the clinical significance of LP-PLA2 concentration. Methods： 202 patients who were diagnosed as having or suspected of coronary heart disease and underwent coronary angiography were selected from January 2015 to July 2015 in our hospital,and medical records,laboratory data and the results of the coronary angiography were obtained. According to the results of coronary angiography,the patients were divided into the control group and the experimental group. According to the clinical symptoms,the experimental group was divided into unstable angina,stable angina and acute myocardial infarction subgroups. According to the coronary artery lesions,the lesions were divided into single vessel lesion,two lesions and three lesions groups. The LP-PLA2 concentration was compared,the Gensini integral was calculated,and the relationship between LP-PLA2 level and Gensini score of patients in each group was analyzed. Results：（ 1）The concentration of LP-PLA2 in the experimental group was significantly higher than that in the control group（ P〈0. 05）.In the experimental group,the concentration of LP-PLA2 was highest in the acute myocardial infarction subgroup.（ 2） There was no significant difference in the concentration of LP-PLA2 among the single vessel lesion,two lesions and three lesions groups.（ 3） The LP-PLA2 concentration and coronary artery Gensini score had a positive correlation： the higher the Gensini score,the higher the LP-PLA2 concentration. Conclusion： The plasma LP-PLA2 concentration is correlated with the degree of coronary artery disease,and can be used to assess the progression of coronary artery disease.